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Homestead_Ballard
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 KAREN HARBISON VP Preparer of the Sales Disclosure Form Title 803 E STATE RD 68 HAUBSTADT STATE BANK Address(Number and Street) Company HAUBSTADT IN 47639 E_SELIMY/GRANTQR(S ,.. f.. T] r�. BILLY D STFVFNS1111 Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveys e do eft"-'j 207 N MAIN ST a Address(Number and Street) Address(Number and Street) O L. Y I 0 2019 FT BRANCH. IN 47648 City,State,and ZIP Code City,State,and ZIP Code E-mail Telephone Number GIBSON ('fUNTY E-mail Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct andcomplete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signature of se&r Signature of Seller BILLY D SIEVFNS 10/04/2019 Printed Name of Seller Sign Date(MM/DD/YYYYl Printed Name of Seller Sign Date(MM/DD/YYYY) F OUYCRS(5)%GRANTEEc . APPLICATI,O,N_FOR PROPERTYfTAX.IIEDU,,C'PIO.NS IDENTIFY.`ALL.ITEMS THAT APPEY._>,_ _.. . —BRUCEA BALLARD JR') Buyer 1-Name as appea� rs on conveyance document Buyer 2•Name as appears on conveyance document 4969 E 1150 S Address(Number and Street) Address(Number and Street) HAUBSTADT IN 47639 City,State,and ZIP Code City,State,and ZIP Code E-mail Telephone Number E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION YES NO CONDITION ❑ 1.Will this property be the buyer's primary ' 77-"❑F3.H steady residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: ❑ ❑✓ 5.Wind Power Device 8496 E 850 S Address(Number and Street) ❑ 6.Hydroelectric Power Device HAUBTADT IN 47639 GIBSON ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ g 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ 0 9.Would you like to receive tax statements for this complete address of residence being vacated, property via e-mail?(Provide contact information including county: below.Please see instructions for more information. Not available in all counties.) Address(Number and Street) 19 22 City,State ZIP Code County " - ` ~�DD- 2O2 , %J'0�0 �) Primary property owner con tact name E-mail Number License/ID/Other Number I J